An Early History of Vaccines
We tend to think about
vaccinations as a modern and Western medical phenomenon. While it’s true that
most major developments in the scientific study of vaccination have taken place
in the past 200 years in Europe and the United States, the rich and varied
origins of vaccinations go back over a thousand years and to locations all
across the globe. The history of vaccinations as we know them today is a prime
example of how human advancements occur not in isolation but rather through a
progressive journey of both milestones and failures.
A recognition of the concept
behind vaccinations—namely that by surviving an infection of a disease a person
can become immune to it—is recorded to have been understood as far back as
Ancient Greece. Greek historian Thucydides observed in 429 BC that people who
contracted but lived through the smallpox plague in Athens were not re-infected
with the disease. This observation was also made some 500 years later in China
sometime between 900 and 1000 CE, with doctors discovering that exposing
healthy people to tissue from the scabs caused by smallpox decreased their
chances of dying from the disease. This process, called variolation, was done
by either putting the tissue under a person’s skin or inserting powder derived
from pulverised smallpox scabs into a person’s nose.
According to written records, a
Chinese statesman’s son was successfully inoculated against smallpox in 1000 CE
through the powder method. This increased the popularity of variolation in the
region, prompting Emperor K’ang, whose father Emperor Fu-lin died of smallpox
in 1661, to write a letter in the late 1600s to his descendants supporting variolation.
In that letter, he admitted to having tested it on many people and having
invested significant resources into its widespread application, despite
significant opposition. He claimed that the inoculations he supported had saved
millions of lives, and encouraged future generations to take up the practice.
Over in the Americas around the
same time, an accidental run-in with variolation resulted in its widespread use
in the West. A Boston minister named Cotton Mather was given a gift of a Libyan
slave in 1706, and the minister noticed that the slave bore a scar from
smallpox variolation back in Libya. The slave claimed that he and others like
him who had been variolated were immune to the disease. Upon discovering this,
Mather became a strong proponent of inoculation. Another Western advocate of
variolation was Lady Mary Montagu, who in 1718 had her six-year-old son
variolated with smallpox in Turkey. When she returned to England in 1721, she
variolated her two-year-old daughter and became a spokesperson for the practice
in Europe.
Given the high number of
outbreaks of smallpox in Europe and the Americas in the 1700s, inoculation was
a highly publicised topic. Many were highly critical of the practice since 2 to
3 percent of those variolated died of the disease, and since the disease could
be spread between those who had been variolated and healthy individuals who had
not. But advocates pointed to the fact that the death rate of individuals who
naturally contracted smallpox was 20 to 30 percent, making inoculation the
safer bet. This assumption was further evidenced in 1738 when smallpox struck
Charleston, South Carolina. Of the 441 people who were variolated against the
disease, around 4 percent of them died, while the smallpox outbreak was fatal for
18 percent of those who were naturally infected.
Then a breakthrough in 1796 by
Dr. Edward Jenner forever changed the frontier of inoculation. Dr. Jenner
proved that inoculation with cowpox matter—a rare disease in cows that can
spread to humans—could protect a person from smallpox. This was the first
discovery of vaccination in its modern form. Word of Dr. Jenner’s success
spread quickly and widely, prompting doctors and scientists across the world to
take up vaccination experiments. A Harvard professor of medicine, Dr. Benjamin
Waterhouse, performed the first modern vaccinations on his own children, and
subsequently received the support of soon-to-be president Thomas Jefferson to
promote the use of vaccinations for children nationwide. Dr. Waterhouse was
permitted by the Department of Health to sponsor a public test, and all 19
volunteers were successfully vaccinated. As a result of these efforts,
Massachusetts became the first U.S. state to encourage smallpox vaccinations in
1802. In 1813, the U.S. Congress authorised and established a vaccine agency to
monitor vaccination research. By 1855, Massachusetts passed the first U.S. law
mandating vaccinations for schoolchildren, with other U.S. states and countries
worldwide following suite.